Comparison of RANKL and OPG levels in peri-implant crevicular fluid between healthy and diseased peri-implant tissues. A systematic review and meta-analysis.

OBJECTIVES: To assess RANKL and OPG levels, as well as RANKL/OPG ratio, in peri-implant crevicular fluid (PICF), in dental implants presenting peri-implantitis (PI) in comparison to healthy implants (H) and to implants with peri-implant mucositis (MU). MATERIALS AND METHODS: An electronic search based on the PICO framework, supplemented by hand searching, was conducted in MEDLINE and EMBASE, using the Ovid interface from 1996 up to and including the 17th of December 2019 in order to identify relevant clinical studies. A combination of MeSH terms and text words was utilized for this purpose. Sequential screenings at the title, abstract, and full-text levels were performed independently and in duplicate. A random-effects meta-analysis was conducted and mean value standardized differences, between PI and H groups, were utilized as effect sizes. RESULTS: Out of 1961 titles, which were revealed by the search strategy, 11 articles fulfilled the inclusion criteria and were incorporated in the systematic review. Meta-analytical processing was performed for RANKL (4 articles), OPG (5 articles), and RANKL/OPG ratio (5 articles) in PI and H groups. The total effect for RANKL mean differences between PI and H groups indicated a tendency but not a statistical significance (P = 0.078) in favor of the PI group, while no statistically significant differences were found for OPG and the ratio levels in the examined groups. CONCLUSIONS: There is limited evidence that levels of the examined biomarkers, RANKL, and OPG as well as the RANKL/OPG ratio, in PICF, may be considered strong indicators for distinguishing between healthy and inflamed peri-implant sites. CLINICAL RELEVANCE: Biomarker identification in PICF, which could differentiate between healthy and diseased dental implants, might represent a valuable non-invasive method suitable for implant pathology and implant therapy prognosis.

Characteristics and treatment of invasive cervical resorption in vital teeth. A narrative review and a report of two cases.

Invasive cervical resorption (ICR) is a significant defect of the root surface where the hard dental tissues are undermined and become translucent due to the resorptive granulomatous tissue. It is mainly detected on radiographs. The radiographic appearance of ICR is asymmetrical radiolucency with irregular margins and an unchanged root canal. The purpose of this study is to present a comprehensive review together with the characteristics and the treatment of ICR through two cases which were followed-up for 36 months. In both cases the teeth were vital and the management consisted of raising a flap, granulomatous tissue removal, thorough debridement, restoration of the resorptive defect by placing a suitable filling material and follow-up examinations. Our results indicate that the specific treatment protocol has very positive outcomes. After 36 months pulpal vitality tests revealed a healthy pulp, and clinical and radiographic examination confirmed a stable periodontal condition.

Association between oral malodour and periodontal disease-related parameters in the general population.

AIM: To determine the association between halitosis detection and periodontal status in systemically healthy non-smokers and to assess whether halitosis was related to quantities of Fusobacterium nucleatum and Porphyromonas gingivalis on the tongue dorsum. METHODS: Periodontal examinations, tongue coating determination, Halimeter® readings and organoleptic assessments of mouth odour were performed in 28 chronic periodontitis patients, 23 chronic gingivitis patients and 27 healthy individuals. The quantities of P. gingivalis and F. nucleatum were determined in tongue specimens by real-time PCR. RESULTS: Halitosis was more likely to be detected in patients with periodontitis (OR = 9.2) and gingivitis (OR = 4.6) than in healthy subjects. The posterior tongue odour was similar for all groups; had the highest score of all organoleptic assessments and was significantly correlated with Halimeter® scores and the odour of the whole mouth air. Periodontitis patients harboured significantly greater amounts of P. gingivalis on their tongue, yet similar quantities of F. nucleatum compared to gingivitis patients and healthy subjects. The amount of P. gingivalis residing on the tongue dorsum of periodontitis patients was significantly associated with halitosis recordings, while the amount of F. nucleatum was related to tongue coating in healthy controls, which corroborates its role in biofilm formation. CONCLUSIONS: Patients with periodontal disease were at higher risk for halitosis detection than healthy individuals. The posterior portion of the tongue dorsum seems to be an important source of odourous compounds, regardless of periodontal condition. P. gingivalis residing on the tongue of periodontitis patients may play a key role in oral malodour production.

The use of tetracycline fibres in the treatment of generalised aggressive periodontitis: clinical and microbiological findings.

The purpose of the present study was to evaluate the effects of tetracycline fibres (TCF) as an adjunct to scaling in the treatment of generalised aggressive periodontitis and to compare the effects with mechanical treatment only. Ten patients, 24-39 years old referred for treatment to the Department of Preventive Dentistry, Periodontology and Implant Biology, Aristotle University of Thessaloniki took part in the study. A split-mouth experimental design was used. Measurements referring to bleeding on probing (BOP), pocket depth (PD) and clinical attachment level (CAL) were performed at 12 sites randomly selected. Clinical recordings were made at baseline, 2 and 6 months, after treatment. Subgingival plaque samples were taken for microbiological analysis using the 'checkerboard' DNA-DNA hybridisation technique at baseline, immediately after treatment and at 2 and 6 months. Full-mouth scaling and root planing were performed, with the exception of 2 pre-selected sites, which served as controls. Tetracycline fibres were applied in 5 pockets located in the same half mouth. Analysis of clinical findings showed that mechanical instrumentation in combination with TCF application led to a greater improvement in clinical parameters than scaling and root planing only. Microbial analysis showed a statistically significant greater reduction in the percentages of detection for B. forsythus, P. nigrescens and A. naeslundii genospecies II in pockets where tetracycline fibres were applied. In conclusion, the clinical and microbiological data of the present study suggest that the adjunctive use of TCF improves the clinical response of scaling and root planing in aggressive periodontitis patients.

Effect of non-surgical periodontal therapy in an undergraduate dental clinic. Results one year following treatment.

The aim of the present study was to evaluate the effectiveness of non-surgical treatment of moderately to severely advanced periodontitis in patients at the Department of Periodontology of the Aristotle University of Thessaloniki. The patients were treated by senior students of the Dental School under the supervision of specialized personnel. The conservative treatment consisted of oral hygiene instructions and repeated instrumentation (scaling and root planing) for a period of about 3 months. Seventeen patients with advanced periodontitis participated in the study. The following data were recorded: 1. Gingival index (Silness and Löe, 1963), 2. Plaque index (Löe and Silness 1964), 3. Bleeding on probing and 4. Pocket depth and probing attachment level. The measurements were taken by the same examiner four times, that is at baseline, immediately after completion of the conservative therapy, 6 months and 12 months after treatment. Measurements from single and multi-rooted teeth were divided into three groups with respect to the initial pocket depth (less than or equal to 3 mm, 4-6 mm, greater than or equal to 7 mm). The findings of the present study demonstrated that non-surgical therapy can achieved a marked reduction in bleeding on probing scores and pocket depth 12 months after treatment. A gain in probing attachment levels was found for sites with initially deep (greater than or equal to 7 mm) and moderate (4-6 mm) pockets, while in sites with initially shallow pockets (less than or equal to 3.0 mm), a loss of attachment level was established.